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Inflammatory and prothrombotic activation with conserved endothelial function in patients with chronic, asymptomatic

Ramón N Herrera1, Elba I Díaz de Amaya, Rossana C Pérez Aguilar

  • 1Haemostasis and Thrombosis Department, Zenón J. Santillán Hospital Health Center, Facultad de Medicina, Universidad Nacional de Tucumán, Tucumán, Argentina.

Clinical and Applied Thrombosis/Hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
|August 12, 2010
PubMed

Insights

Asymptomatic chronic Chagas disease patients show a prothrombotic and inflammatory state, indicated by elevated markers. Preserved endothelial function suggests early cardiovascular damage mechanisms.

Area of Science:

  • Cardiovascular Medicine
  • Infectious Diseases
  • Immunology

Background:

  • Chronic Chagas disease, caused by Trypanosoma cruzi, can lead to a prothrombotic state.
  • Previous research from our group identified this prothrombotic state in asymptomatic patients.

Purpose of the Study:

  • To investigate the inflammatory status and endothelial function in asymptomatic patients with chronic Chagas disease.
  • To further characterize the prothrombotic state in this patient population.

Main Methods:

  • Evaluated prothrombotic markers (prothrombin fragment 1 + 2, d-dimer, PAI-1, fibrinogen) and blood parasitemia via PCR in 40 patients and 40 controls.
  • Assessed inflammatory markers including tissue factor pathway inhibitor antibodies (aTFPI), interleukin-6 (IL-6), and vascular cell adhesion molecule-1 (VCAM-1).
  • Determined endothelial function using reactive hyperemia and pulse plethysmography.

Main Results:

  • Patients exhibited significantly higher levels of prothrombin fragment 1 + 2, d-dimer, PAI-1, and fibrinogen.
  • Trypanosoma cruzi DNA was detected in 45% of patients.
  • Elevated aTFPI-IgG, aTFPI-IgM, IL-6, and VCAM-1 were observed in patients compared to controls.
  • Endothelial function was preserved in both patients and healthy volunteers.

Conclusions:

  • Asymptomatic chronic Chagas disease is associated with a prothrombotic and inflammatory status.
  • The preservation of endothelial function suggests that prothrombosis and inflammation are early contributors to cardiovascular damage in Chagas disease.
  • These findings highlight potential therapeutic targets for preventing cardiovascular complications.
Abstract

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